Nursing Students’ Practicums during the COVID-19 Crisis and the Effect on Infection-Prevention Behavior in Students: A Mixed-Method Approach
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design, Setting, and Participants
Operational Definition of Terms
2.2. Procedure
2.2.1. Qualitative Research
Data Collection Procedure
Interview Content
2.2.2. Quantitative Research
Items in the Questionnaire-Based Survey
- (1)
- Participant attributes: age, gender, number of clinical placement practicums, and health status.
- (2)
- Motivations: Factors related to anxiety before and after preparation for practicums.
- (3)
- Acquisition of knowledge and skills: Subjects studied and practicum orientation topics that were helpful for IPMs during the practicums.
- (4)
- Nursing practice: IPMs learned during practicums, IPMs used by students, and difficulties faced during practicums.
2.3. Statistical Analysis
2.3.1. Qualitative Research
2.3.2. Quantitative Research
3. Results
3.1. Qualitative Research
3.1.1. Overview of the Participants
3.1.2. Results of the Analysis
3.2. Quantitative Research
3.2.1. Overview of the Participants
3.2.2. Learning about IIPMs from the Pre-Practicum Orientation and Previously Completed Subjects
3.2.3. Changes in Anxiety Factors before and after Practicums
3.2.4. A Comparison of Infection Control Measures Learned by Students from a Clinical Nurse and a Nursing Lecturer
3.2.5. Students’ Difficulties Surrounding IPMs
3.2.6. Changes in IPBs during and after the Practicum
3.2.7. IPMs Practiced after the Practicums
4. Discussion
4.1. The Effect of Infection Prevention Measure Education Provided through Pre-Practicum Orientation and Practicums on the IPB of Students
4.2. Promoting and Inhibiting Changes in Infection Prevention Behaviors
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Category | Subcategory | Code |
---|---|---|
Acquisition of knowledge and skills in IPMs during nursing practice | Re-confirmation of hand hygiene methods | Confirmation of students’ knowledge of hand sanitizing by the practicum supervisor |
Learning about clinical infection control (including hand hygiene) from a nurse certified in infection control | ||
Learning about the correct usage of PPE | Skill acquisition for correct use and removal of masks, goggles, face shields, and aprons | |
Learning how to care for patients with fever from the perspective of a nurse wearing PPE | ||
Minimizing patient contact time by shortening care time | Noticing that shortening care time takes precedence over infection control | |
Learning about the difference in time required for acquiring nursing skills in on-campus practice situations and clinical placement practicums | ||
Hospital bed management for infected patients | Learning about zoning | |
Learning about the role of the infection control division and the human resources involved in infection management | ||
Learning about nurse placements for infection control as well as bed control measures | ||
Thorough IPM implementation through supervision and strict adherence | Filling out the health/behavior management chart starting from 2 weeks before practicums | |
Increasing the frequency of glove changing and sanitizing during patient care | ||
Sharing information about infection control at conferences | ||
Cleanliness care from the perspective of cleanliness/lack of hygiene as instructed by a nurse | ||
Wearing a mask at lunchtime and keeping your distance from others | ||
Defining the experience in IPMs | Motivation for becoming a nurse | Learning the joy of nursing from the reactions of patients |
Noticing the importance of practicing patient care in clinical placement practicums | ||
From nursing practicums, aiming to be a nurse that patients need | ||
Gratitude and respect for patients/medical professionals | Tension from biases towards medical professionals as presented in the media | |
The feeling of gratitude for being able to partake in practicums despite the COVID-19 crisis | ||
Changes in attitude towards infection | Anxiety about infection before practicums | Student anxiety about infecting patients, medical professionals, or family |
Anxiety about infection when traveling by train to the clinical placement practicums | ||
Anxiety about lack of PPE at practicum facilities | ||
Anxiety about the discontinuation of the practicum or grades if a student gets infected | ||
The expectation for learning during practicums | Eagerness to learn during clinical placement practicums | |
Encouragement from parents to learn during clinical placement practicums | ||
The expectation of learning from the first on-campus practice session | ||
Relief and a feeling of achievement after safe completion of the practicums | Not getting sick so breathing easy | |
Reassurance that there were no infections among patients or medical professionals and no students who infected medical professionals | ||
A feeling of achievement after safe completion of the practicums | ||
Changes in IPB | Thinking about IPM from the perspective of daily routines | Heightened awareness of health management from filling out the health/behavior management chart |
Motivation for IPM adherence from the pre-practicum and practicum orientation | ||
Making handwashing and mask-wearing habits | ||
Gathering information relating to infections from reliable information sources | ||
Reducing the number of people one goes out with | ||
Changing from train to bicycle transport to get to campus | ||
IPM for family | Reducing outings and eating out times with family | |
Reducing opportunities to have contact with grandparents | ||
Making changes to part-time work | ||
IPM-related issues | Stress due to IPM | Not being able to get a change in scenery after practicums due to outing limitations |
Hand irritation due to frequent handwashing and sanitizing | ||
The difficulty of use due to goggles fogging up or slipping off | ||
Closeness when communicating with patients with hearing difficulties | ||
Hesitancy towards health consultations if a fever develops | Keeping things to oneself | |
Hesitancy in terms of consulting with others | ||
A feeling of guilt | ||
Concern about the effect on grades | ||
Lack of knowledge and skills from basic subjects | Lack of knowledge of microbiology and infectious disease medicine | |
Lack of knowledge of hand sanitizer or disinfectant drugs |
Attribute | Meanor Number (n = 81) | SD or % | |
---|---|---|---|
Age | 21.3 | 0.7 | |
Gender | Male | 12 | 14.8 |
Female | 66 | 81.5 | |
Others | 3 | 3.7 | |
Fever of 37.5 °C or higher during the practicum period | Yes | 6 | 7.4 |
No | 75 | 92.6 | |
Field of participation on all the days of the clinical placement practicums | Adult nursing | 68 | 84.0 |
Gerontological nursing | 16 | 19.8 | |
Women’s health nursing | 12 | 14.8 | |
Community health nursing | 12 | 14.8 | |
Child health nursing | 6 | 7.4 | |
Psychiatric and mental health nursing | 0 | 0 | |
Frequency of clinical placement practicums (No. of fields) | 2.3 | 3.0 | |
Feelings towards clinical placement practicums | Want to go | 40 | 49.4 |
Do not want to go | 12 | 14.8 | |
No choice | 41 | 50.6 |
IPM-Related Topics from Pre-Practicum Orientations | No. of People | % | |
---|---|---|---|
Participation in pre-practicum orientations | Less than 3 sessions | 34 | 42.0 |
3 or more sessions | 47 | 58.0 | |
Orientation topics that were helpful for IPMs | Standard precautions | 63 | 77.8 |
Infection route | 61 | 75.3 | |
Timing of hand sanitizing | 58 | 71.6 | |
Cleanliness/Lack of hygiene | 42 | 51.9 | |
Chain of Infection | 40 | 49.4 | |
A limited movement to cluster areas | 40 | 49.4 | |
Avoid the three Cs | 32 | 39.5 | |
Correct usage of PPE | 24 | 29.6 | |
Virus incubation period | 23 | 28.4 | |
Virus survival period | 20 | 24.7 |
Anxiety Factor | Before Practicums (n = 81) | After Practicums (n = 81) | p | ||
---|---|---|---|---|---|
n | % | n | % | ||
A student infecting someone else | 54 | 66.7 | 45 | 55.6 | <0.01 |
A student being infected by someone else | 54 | 66.7 | 45 | 55.6 | <0.01 |
Train travel | 42 | 51.9 | 22 | 27.2 | <0.01 |
Cancellation of the practicum due to infection | 41 | 50.6 | 10 | 12.3 | <0.01 |
Lack of nursing skills | 33 | 40.7 | 16 | 19.8 | <0.01 |
The possibility of fever | 26 | 32.1 | 25 | 30.9 | <0.01 |
Lack of knowledge of infection control | 8 | 9.9 | 5 | 6.2 | <0.01 |
Item | Clinical Nurse (n = 81) | Nursing Lecturer (n = 81) | p | ||
---|---|---|---|---|---|
n | % | n | % | ||
Correct usage of PPE | 60 | 74.1 | 54 | 66.7 | <0.01 |
Hand Hygiene | 59 | 72.8 | 48 | 59.3 | <0.01 |
Standard precautions | 52 | 64.2 | 51 | 63.0 | <0.01 |
Infection risk factors | 50 | 61.7 | 43 | 53.1 | <0.01 |
Nursing skills with consideration for infection prevention | 46 | 56.8 | 35 | 43.2 | <0.01 |
Distancing from patients | 35 | 42.3 | 30 | 37.0 | <0.01 |
Infection prevention at lunchtime | 33 | 40.7 | 45 | 55.6 | <0.01 |
Strict adherence to IPM | 23 | 28.4 | 19 | 23.5 | <0.01 |
Shortening care time | 17 | 21.0 | 23 | 28.4 | <0.01 |
The role of the infection control manager | 16 | 19.8 | 10 | 12.3 | <0.01 |
Item | During the Practicum (n = 81) | After the Practicum (n = 81) | p | ||
---|---|---|---|---|---|
n | % | n | % | ||
Hand hygiene | 79 | 97.5 | 76 | 93.8 | <0.01 |
Mask wearing | 79 | 97.5 | 74 | 91.4 | <0.01 |
Avoiding outings | 68 | 84.0 | 56 | 69.1 | <0.01 |
Avoiding eating out | 64 | 79.0 | 55 | 67.9 | <0.01 |
Avoiding the three Cs | 60 | 74.1 | 56 | 69.1 | <0.05 |
Improving daily routines (meals and exercise) | 17 | 21.0 | 15 | 18.5 | <0.01 |
Infection prevention at lunchtime | 43 | 53.1 | 21 | 25.9 | <0.01 |
Behavior that Continued after the Practicums | Participation in Orientation | p | Experience in Clinical Placement Practicums | p | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Less than 3 Sessions (n = 34) | 3 or more Sessions (n = 47) | Less than 3 Sessions (n = 64) | 3 or more Sessions (n = 17) | |||||||
n | % | n | % | n | % | n | % | |||
Hand Hygiene | 28 | 82.4 | 42 | 89.4 | 0.36 | 59 | 92.2 | 11 | 64.7 | <0.01 |
Avoiding the three Cs | 19 | 55.9 | 37 | 78.7 | <0.05 | 45 | 70.3 | 11 | 64.7 | 0.66 |
Infection prevention at lunchtime | 19 | 55.9 | 37 | 78.7 | <0.05 | 16 | 25.0 | 5 | 29.4 | 0.71 |
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Nakagawa, H.; Sasai, H. Nursing Students’ Practicums during the COVID-19 Crisis and the Effect on Infection-Prevention Behavior in Students: A Mixed-Method Approach. Medicina 2021, 57, 1354. https://doi.org/10.3390/medicina57121354
Nakagawa H, Sasai H. Nursing Students’ Practicums during the COVID-19 Crisis and the Effect on Infection-Prevention Behavior in Students: A Mixed-Method Approach. Medicina. 2021; 57(12):1354. https://doi.org/10.3390/medicina57121354
Chicago/Turabian StyleNakagawa, Hiromi, and Hiroyuki Sasai. 2021. "Nursing Students’ Practicums during the COVID-19 Crisis and the Effect on Infection-Prevention Behavior in Students: A Mixed-Method Approach" Medicina 57, no. 12: 1354. https://doi.org/10.3390/medicina57121354